In-Office Needle Arthroscopy: Indications, Surgical Techniques, Tips, and Tricks

Abstract

In-office needle arthroscopy (IONA) has gained increased attention as a minimally invasive alternative to standard arthroscopy performed in the operating room (OR) setting. IONA uses instrumentation that is markedly smaller in size and diameter making arthroscopy less invasive. Less OR equipment and less OR staff are required resulting in procedures that may be more accessible and less expensive. IONA is typically performed using local intra-articular blocks, thereby reducing the need for regional anesthesia or general anesthesia along with its associated risks. Using a clinic setting rather than an OR reduces the cost and increases the efficiency of the procedure. This article will present the indications for IONA in upper and lower extremity injuries and will describe the best practice office setup. Technical pearls and pitfalls will also be discussed.

Figure 1

Images demonstrating the in-office room setup

Figure 2

A, Images demonstrating the IONA anterior and posterior ankle setup. B, Image demonstrating the IONA knee setup. C, Image demonstrating the IONA shoulder setup. D, Image demonstrating the IONA wrist setup. IONA = in-office needle arthroscopy